scholarly journals Ensuring Consistent European-Wide Urological Care by the Use of Evidence-Based Clinical Practice Guidelines: Can We Do Better

2017 ◽  
Vol 2 (Suppl. 1) ◽  
pp. 1-7
Author(s):  
Emma Jane Smith ◽  
Steven MacLennan ◽  
Anders Bjartell ◽  
Alberto Briganti ◽  
Thomas Knoll ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
Scientific Evidence ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Evidence Based ◽  
Robust Methods ◽  
Practice Recommendations

The European Association of Urology (EAU) annually updates 21 clinical practice guidelines in which summaries of the evidence base and best practice recommendations are made. The methodology applied to achieve this and integrate stakeholder opinion is continuously improving. However, there is evidence to suggest wide variation in clinical practice indicating that many patients receive suboptimal and heterogeneous care. Studies from certain countries suggest that 2 out of 5 patients do not receive care according to the current scientific evidence, and in 1 out of 4 cases the care provided is potentially harmful. Clearly, the harmonisation of care in alignment with evidence-based best practice recommendations is something to strive for. Development of robust methods to disseminate and implement guideline recommendations and measure their impact is an objective the EAU is committed to improving. An important strategy for achieving harmonisation in urological care across Europe is to ensure the availability of high-quality clinical practice guidelines and to actively promote their implementation by clinicians and healthcare providers.

scholarly journals The Italian Society for Rheumatology clinical practice guidelines for the diagnosis and management of fibromyalgia Best practices based on current scientific evidence

Reumatismo ◽  
2021 ◽  
Vol 73 (2) ◽  
pp. 89-105
Author(s):  
A. Ariani ◽  
L. Bazzichi ◽  
P. Sarzi-Puttini ◽  
F. Salaffi ◽  
M. Manara ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Working Group ◽  
Best Practice ◽  
Scientific Evidence ◽  
Grey Literature ◽  
Italian Society ◽  
Pharmacological Management ◽  
Social Burden

Fibromyalgia or fibromyalgia syndrome (FMS) is defined as a central sensitization syndrome characterized by the dysfunction of neurocircuits detecting, transmitting and processing nociceptive stimuli; the prevalent manifestation is musculoskeletal pain. In addition to pain, there are multiple accompanying symptoms, in common with other algo-dysfunctional syndromes, which are reflected in a broad spectrum of somatic, neurocognitive and neuro-vegetative manifestations. An evidence-based approach is essential in FMS management, in order to improve patient health and to reduce its social burden. Since in the last ten years new international guidelines for clinical practice (Clinical Practice Guidelines or CPGs) concerning FMS diagnosis and pharmacological/ non-pharmacological management have been published, the Italian Society of Rheumatology (SIR) has decided to adapt them to the Italian national setting. The framework of the Guidelines International Network Adaptation Working Group was adopted to identify, appraise (AGREE II), synthesize, and customize the most recent CPGs on FMS to the needs of the Italian healthcare context. A working group of rheumatologists from SIR epidemiology unit and FMS experts identified relevant clinical questions to guide the systematic review of the literature. The target audience of these CPGs included physicians and healthcare professionals who manage FMS. The adapted recommendations were finally assessed by an external multidisciplinary panel. From the systematic search in databases (Pubmed/Medline, Embase) and grey literature, 6 CPGs were selected and appraised by two independent raters. The combination of the scientific evidence underlying the original CPGs with expert opinion lead to the development of 17 recommendations. The quality of evidence for each recommendation was reported and their potential impact on clinical practice was assessed. These SIR recommendations are expected to be a valuable aid in the diagnosis and treatment of FMS, as they will contribute to disseminate the best practice on the basis of the current scientific evidence.

scholarly journals International Examination and Synthesis of the Primary and Secondary Surveys in Paramedicine

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Marc A Colbeck ◽  
Sonja Maria ◽  
Georgette Eaton ◽  
Craig B Campbell ◽  
Alan M Batt ◽  
...  
Keyword(s):  
South Africa ◽  
Clinical Practice ◽  
United Arab Emirates ◽  
Practice Guidelines ◽  
Best Practice ◽  
Evidence Based ◽  
Treatment Algorithms ◽  
Practice Recommendations ◽  
Assessment And Treatment ◽  
Secondary Survey

<p class="Pa2"><strong>Background</strong></p><p class="Pa2">To guide their care paramedics routinely rely upon two assessment and treatment algorithms, known as the primary survey and the secondary survey.  No clear consensus of the concepts (assessments and interventions) that are, or should be, included in these algorithms exist internationally. </p><p class="Pa2"><strong>Methods </strong></p><p class="Pa2">This paper evaluated Australasian paramedic clinical practice guidelines (CPGs), as well as six other international paramedic CPGs (USA, Ireland, UK, South Africa, Qatar, and the United Arab Emirates) in order to identify which concepts are currently described in best-practice recommendations for paramedics.  The authors also contributed concepts that they felt were important additions based on their experience as veteran paramedics and paramedic educators.</p><p class="Pa2"><strong>Results </strong></p><p class="Pa2">The resulting amalgamation of concepts identified in each term was then formed into two mnemonics which, together sequentially list approximately 100 specific clinical concepts that paramedics routinely consider in their care of patients. We describe these as the “International Paramedic Primary and Secondary Surveys”.</p><p class="Pa2"><strong>Conclusion </strong></p><p class="Pa2">The primary and secondary surveys presented in this paper represent an evidence-based guide to the best practice in conducting a primary and secondary survey in the paramedic context.  Findings will be of use to paramedics, paramedic students, and other clinicians working in remote or isolated practices.</p>

scholarly journals Integrating evidence-based interventions in clinical settings in Jordan: a policy brief

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 933
Author(s):  
Mohammad Alzaatreh ◽  
Obay A. Al-Maraira ◽  
Nazih Abu Tabar ◽  
Mohammad R. Alsadi ◽  
Huthaifah Khrais ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Research Utilization ◽  
Action Plan ◽  
Healthcare Providers ◽  
Clinical Settings ◽  
Evidence Based ◽  
Analysis And Evaluation ◽  
New Evidence

Background: Evidence-based nursing practice (EBNP) is considered a major and very important global paradigm shift. Unfortunately, most healthcare providers and researchers embrace the concept of evidence-based practice (EBP) without integrating this concept in clinical settings. The current situation of EBP and new practice guidelines utilization in Jordan are scarce. This policy brief aimed to discusses the process of utilizing nursing EBP in clinical settings in Jordan. Methods: The authors adopted an action plan utilizing a systematic approach to develop and implement specific strategies and policies to integrate EBP in clinical settings in Jordanian hospitals. We present an experience of one country in terms of introducing a policy brief to establish an EBP policy accompanied by developing an EBP unit in the hospital's country. Results: A comprehensive description of this policy is provided with reference to the eminent steps of policy analysis and evaluation. In fact, EBP policies and clinical practice guidelines should keep a live document and revise regularly or as needed. Overall, the authors suggest the development of a unit for EBP to deal with issues related to clinical practice guidelines. Conclusions: Expected outcomes for the introduction of the EBP unit and its policy include increase research utilization and accelerated adoption of new evidence, increase the quality of care provided, increase patient, staff, and managers satisfaction, and decrease staff workload by reducing complications associated with medical errors and outdated interventions.

scholarly journals Determinants of clinical practice guidelines’ utilization for the management of musculoskeletal disorders: a scoping review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Delphine Sorondo ◽  
Cyrille Delpierre ◽  
Pierre Côté ◽  
Louis-Rachid Salmi ◽  
Christine Cedraschi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Musculoskeletal Disorders ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Scoping Review ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional

Abstract Context Many clinical practice guidelines have been developed for the management of musculoskeletal disorders (MSDs). However, there is a gap between evidence-based knowledge and clinical practice, and reasons are poorly understood. Understanding why healthcare providers use clinical practice guidelines is essential to improve their implementation, dissemination, and adherence. Aim To identify determinants of clinical practice guidelines’ utilization by health care providers involved in the assessment and management of MSDs. Method A scoping review of the literature was conducted. Three databases were searched from inception to March 2021. Article identification, study design, methodological quality, type of healthcare providers, MSDs, barriers and facilitators associated with guidelines’ utilization were extracted from selected articles. RESULTS: 8671 citations were retrieved, and 43 articles were selected. 51% of studies were from Europe, and most were quantitative studies (64%) following a cross-sectional design (88%). Almost 80% of articles dealt with low back pain guidelines, and the most studied healthcare providers were general practitioners or physiotherapists. Five main barriers to guideline utilization were expressed by providers: 1) disagreement between recommendations and patient expectations; 2) guidelines not specific to individual patients; 3) unfamiliarity with “non-specific” term, or with the bio psychosocial model of MSDs; 4) time consuming; and 5) heterogeneity in guideline methods. Four main facilitators to guideline utilization were cited: 1) clinician’s interest in evidence-based practice; 2) perception from clinicians that the guideline will improve triage, diagnosis and management; 3) time efficiency; and 4) standardized language. Conclusion Identifying modifiable determinants is the first step in developing implementation strategies to improve guideline utilization in clinical practice.

scholarly journals Determinants of clinical practice guidelines’ utilization for the management of musculoskeletal disorders: A scoping review

2020 ◽  
Author(s):  
Delphine Sorondo ◽  
Cyrille Delpierre ◽  
Pierre Côté ◽  
Louis-Rachid Salmi ◽  
Christine Cedraschi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Musculoskeletal Disorders ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Scoping Review ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional

Abstract CONTEXT: Many clinical practice guidelines have been developed for the management of musculoskeletal disorders (MSDs). However, there is a gap between evidence-based knowledge and clinical practice, and reasons are poorly understood. Understanding why healthcare providers use clinical practice guidelines is essential to improve their implementation, dissemination, and adherence.AIM: To identify determinants of clinical practice guidelines’ utilization by health care providers involved in the assessment and management of MSDs.METHOD: A scoping review of the literature was conducted. Three databases were searched from inception to December 2019. Article identification, study design, methodological quality, type of healthcare providers, MSDs, barriers and facilitators associated with guidelines’ utilization were extracted from selected articles.RESULTS: 7667 citations were retrieved, and 43 articles were selected. 51% of studies were from Europe, and most were quantitative studies (64%) following a cross-sectional design (88%). Almost 80% of articles dealt with low back pain guidelines, and the most studied healthcare providers were general practitioners or physiotherapists. Five main barriers to guideline utilization were expressed by providers: 1) disagreement between recommendations and patient expectations; 2) guidelines not specific to individual patients; 3) unfamiliarity with “non-specific” term, or with the bio psychosocial model of MSDs; 4) time consuming; and 5) heterogeneity in guideline methods. Four main facilitators to guideline utilization were cited: 1) clinician’s interest in evidence-based practice; 2) perception from clinicians that the guideline will improve triage, diagnosis and management; 3) time efficiency; and 4) standardized language.CONCLUSION: Identifying modifiable determinants is the first step in developing implementation strategies to improve guideline utilization in clinical practice.

Clinical practice guidelines for comprehensive patient assessment in emergency care: A quality evaluation study

2021 ◽  
pp. 205715852110069
Author(s):  
Åsa Falchenberg ◽  
Ulf Andersson ◽  
Birgitta Wireklint Sundström ◽  
Anders Bremer ◽  
Henrik Andersson
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Emergency Care ◽  
Quality Evaluation ◽  
Evaluation Study ◽  
Evidence Based ◽  
Patient Assessment ◽  
Care Needs ◽  
Home Based

Emergency care nurses (ECNs) face several challenges when they assess patients with different symptoms, signs, and conditions to determine patients’ care needs. Patients’ care needs do not always originate from physical or biomedical dysfunctions. To provide effective patient-centred care, ECNs must be sensitive to patients’ unique medical, physical, psychological, social, and existential needs. Clinical practice guidelines (CPGs) provide guidance for ECNs in such assessments. The aim of this study was to evaluate the quality of CPGs for comprehensive patient assessments in emergency care. A quality evaluation study was conducted in Sweden in 2017. Managers from 97 organizations (25 emergency medical services and 72 emergency departments) were contacted, covering all 20 Swedish county councils. Fifteen guidelines were appraised using the validated Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. The results revealed that various CPGs are used in emergency care, but none of the CPGs support ECNs in performing a comprehensive patient assessment; rather, the CPGs address parts of the assessment primarily related to biomedical needs. The results also demonstrate that the foundation for evidence-based CPGs is weak and cannot confirm that an ECN has the prerequisites to assess patients and refer them to treatment, such as home-based self-care. This may indicate that Swedish emergency care services utilize non-evidence-based guidelines. This implies that ECN managers and educators should actively seek more effective ways of highlighting and safeguarding patients’ various care needs using more comprehensive guidelines.

scholarly journals Defining key questions for clinical practice guidelines: a novel approach for developing clinically relevant questions

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Samantha Chakraborty ◽  
Bianca Brijnath ◽  
Jacinta Dermentzis ◽  
Danielle Mazza
Keyword(s):  
Qualitative Research ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
International Guideline ◽  
Novel Approach ◽  
Clinical Questions ◽  
Key Questions

Abstract Background There is no standardised protocol for developing clinically relevant guideline questions. We aimed to create such a protocol and to apply it to developing a new guideline. Methods We reviewed international guideline manuals and, through consensus, combined steps for developing clinical questions to produce a best-practice protocol that incorporated qualitative research. The protocol was applied to develop clinical questions for a guideline for general practitioners. Results A best-practice protocol incorporating qualitative research was created. Using the protocol, we developed 10 clinical questions that spanned diagnosis, management and follow-up. Conclusions Guideline developers can apply this protocol to develop clinically relevant guideline questions.

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